In cutting or severing a nerve or other anatomical structure a number of critical factors and circumstances must be taken into consideration for achievement of a successful surgical procedure. The actual cutting action, for example, must be accomplished without cutting any adjacent structure, and such cutting action often doesn't require direct visualization of the structure being cut. Indeed, with certain types of surgical procedures, non-visualization is often preferred. Moreover, there are other procedures, such as common digital neuroma excision in the foot, where severance of the nerve as far away from the main site of surgical dissection is preferred. By severing the anatomical structure as far as possible from the main surgical site as is surgically prudent, postoperative complications such as recurrent nerve entrapment are minimized. In addition, the positioning of the scissors in proximity to and then over the structure to be cut, and then the further movement of the scissors along the structure as far from the surgical site as determined to be prudent by the surgeon, and to the exclusion of any surrounding structure, must be carefully and unobtrusively accomplished. Thus, the proper use of surgical cutting instruments must provide for the optimal severance of the anatomical structure as far away from the main surgical site as is practical and clinically indicated in order to decrease the chances for post-operative complications such as symptomatic soft tissue structure entrapment within the area that defines the most concentrated operative scarring.
Thus, the prior art discloses a number of surgical cutting instruments, prominent among them are the Steinberg et al. patent (U.S. Pat. No. 5,746,748) that discloses a circumcision instrument that includes pivotally interconnected cross members that includes handles with finger loops at a proximal end jaws at a distal end with the jaws having surfaces that contact and clamp tissue therebetween for severing.
The Wales patent (U.S. Pat. No. 5,800,449) discloses a knife shield for surgical instruments that includes a handle from which a tube extends and which encloses therein a tissue stop for protecting tissue engaged by the jaws of the forceps until the surgeon desires to cut the tissue.
The Eubanks, Jr. et al. patent (U.S. Pat. No. 5,593,420) discloses a miniature endoscopic surgical instrument assembly and method of use that includes a securing mechanism for securing a miniature medical implement member to a support sheath so that the support sheath strengthens the implement member and prevents the implement member from breaking during an endoscopic medical procedure.
Nonetheless, despite the ingenuity of the above devices, there remains a need for a surgical cutting instrument having ergonomic handles that are offset from the main working axis of the instrument and which includes various operational handle positions and cutting jaws that cut in a plane normal to the main axis of the instrument and which are movable concomitant with the movement of the handles to the various positions for properly orienting and aligning the instrument with respect to the anatomical structure before cutting the structure.